It's tough being Jesus in a free society. Scarcity of resources is such a bitch, too.

I think the thing Obama is missing -- and this is serious -- is that people will not make the same economic decisions at different tax rates. The next dollar isn't that important to me if I'm only going to see 38 cents.

This is a widespread problem among people who have never actually worked much or held meaningful jobs for any length of time.

After listening to Obama tonight I am convinced about one thing. He has never even taken his own daughters to a doctor's visit. It sounds like he's talking about an abstract, foreign concept and not something to which most people can relate.

After an hour tonight I'm no more informed. All I remember is the "red pill" and the "blue pill" and "tonsils."

Can he even speak the truth, EVER?He'll not sign the healthcare bill if it increases the deficit?

What fuckin' planet is he from, anyway? Does he think we're that stupid?

I'm sure the journalists in the room ate it up, but I've also heard on the radio audio replays from townhall meetings actual laughter greet Dem congressmen who have tried that BS line that "the bill will pay for itself".

Florida: "They have to WIN elections ... not get them handed to them on a historic platter."

Brilliant and pithy.

Obama has completely lost touch with the common man. He hasn't had to deal with the problems of us mortals since he first stepped foot in the world of academia and realized how much his half-African/half-White, Indonesian-grade school, Hawaiian Prep School background married to his love of Marxist dorm-room pot smoking philosophy impressed all who came into contact with him.

"He hasn't had to deal with the problems of us mortals since he first stepped foot in the world of academia and realized how much his half-African/half-White, Indonesian-grade school, Hawaiian Prep School background married to his love of Marxist dorm-room pot smoking philosophy impressed all who came into contact with him."

Personally, I think doing nothing probably ought to be the default option where government is concerned. Politicians never seem to understand the limitations of government "solutions," i.e. they're usually wasteful, overpriced and produce new problems that we didn't have before.

Pity the government fking stooge who tries to tell me my kid can't have her operation because it isn't efficient.

I'll enjoy that day.

To the government employees who might be reading this blog, you need to hear this message: You one day are going to be put in the position of having to tell the people you govern that they can't have medicine that might save their lives.

To the government employees who might be reading this blog, you need to hear this message: You one day are going to be put in the position of having to tell the people you govern that they can't have medicine that might save their lives. How do you think they're going to react to you telling them that?

Health insurance company employees say that sort of thing to people all the time. They seem to be able to go on with their lives.

If you already have health insurance, the reform we’re proposing will provide you with more security and more stability. It will keep government out of health care decisions, giving you the option to keep your insurance if you’re happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, move, or change your job, you will still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money.

Well, some of it may be true. But I think it a deliberate falsehood the claim that It will keep government out of health care decisions. Of course it won't. How do they expect to make it work if the government doesn't get involved there. It would be involved in deciding what coverages you could have and what you couldn't, and ultimately, likely what treatments will be paid for and which won't.

Also mostly untrue is the claim that giving you the option to keep your insurance if you’re happy with it. This is only true if the policy isn't dropped by either the insurance company or your employer, and is only true up to five years. So, yes, you can keep it, for a little while. But within five years you will be on a qualifying plan approved by the government. Or, you will be paying the government imposed fine if you aren't.

It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. In other words, no high deductible plans like we have now with HSAs.

And finally, "And it will cover preventive care like check-ups and mammograms that save lives and money". Frankly, I don't want to pay for a policy that pays for preventive care like mammograms. Personally, I have never had one, and don't see the need for one. Yet, apparently, I will be paying for mammograms, regardless of any need on my part.

The problem here is that he fails to understand that all this health care costs money. If you have a private plan, the cost of all this preventive medicine will be passed through as premiums. Always. It doesn't get paid for through magic, but rather you will pay for it.

Every single mandatory item will have to be paid for through premiums (except through a government option, as long as we can get the Chinese to buy our notes).

So let me be clear: if we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. If we do not act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate we’re having right now.

How exactly is the proposed health care bill going to help control the budget? I would think a little less "stimulus" and pork barrel spending would do a lot more for bringing the budget under control. And how does mandating coverages for everyone and eliminating most choice in policies help in the least in "your premiums and out-of-pocket costs will continue to skyrocket"?

If you don’t have health insurance, or are a small business looking to cover your employees, you’ll be able to choose a quality, affordable health plan through a health insurance exchange – a marketplace that promotes choice and competition Finally, no insurance company will be allowed to deny you coverage because of a pre-existing medical condition.

Must be a different bill than what we have been looking at. Yes, the goal is apparently competition on price - by eliminating competition on almost everything else in the policies that will be offered.

And, of course, eliminating the pre-existing medical condition limitations will allow people to stay in low benefits policies until they do have health issues, at which time they will move into the high benefit policies. Simple economics.

O-blah-blah-blah-ma. It is really quite extraordinary how he goes on and on and on. The really horrifying thing to me is that I think he actually believes he is making a splendid case and is somewhat mesmerized by his own "eloquence."

Health insurance company employees say that sort of thing to people all the time. They seem to be able to go on with their lives.

Actual health care is not a right in this country! Only the ability to profit from it. For example denying claims and coverage for people that already have illnesses. How are they supposed to make any money anyway!?

Did Obama blame Bush for his "inheriting" the $1+ trillion deficit in the current fiscal year, and yet later take credit for the results of most of that emergency deficit spending for stimulus, TARP, etc.?

I have also pledged that health insurance reform will not add to our deficit over the next decade – and I mean it.

At least he didn't say that he really really really meant it.

This is going to be interesting how he expects to pull this off. Sure, if he could manage to move everyone off of government policies, like Medicare, Medicaid, etc., he might have a chance at this. But it is likely that it will work in just the opposite way, with more and more people moving away from private plans into government ones.

1) Soundbite of the evening: Obama's comment that People are going to have to give up procedures that don't make them better. Polling has shown time and again that people only want national healthcare if it's free and doesn't interfere with their own healthcare. Telling people they're going to have to give up anything is going to drive the polls even further down.

2) Claiming that doctors are intentionally performing "churning" patients to gin up additional profits was stupid, stupid, stupid. First, I don't think any sane person actually believes this is true. Second, people trust their doctors a whole lot more than politicians, so when a politician that their doctor is a liar guess which one's credibility is hurt more? Third, making the doctors the bad guy in this scenario is only going to ensure that more doctors are more vocal in their opposition.

3) Saying he didn't have all the facts and then calling the cops "stupid" was moronic. First, he should have just said he's wasn't there and so he can't comment on it. Responding to the question makes it a news story. Second, the facts (as I understand them thus far) are pretty much that Gates was being a complete ass and the cop cuffed him. He shouldn't have cuffed him because there's nothing per se illegal about being an ass, but Gates doesn't exactly come out of this smelling like a rose and he's not a sympathetic character to begin with. Third, after already offending doctors he should have thought twice about offending cops too. Unlike doctors, most cops are also union members. Attacking your own base is never smart.

4) Obama filibustered his own press conference. As far as I can tell, he never actually answered any question which was posed to him. Especially when asked about rationing, there's no way that people who were concerned about rationing didn't notice that he specifically didn't deny that there was going to be rationing.

Obama is self-mesmerizing. he pronounces words oddly, so they have deeper resonance in his throat (example, "Chicago"). Watching him speak is like watching someone pleasure himself, which is why I always either hit the mute button or change the channel.

"Having a public plan out there that also shows that maybe if you take some of the profit motive out, maybe if you are reducing some of the administrative costs, that you can get an even better deal, that's going to incentivize the private sector to do even better."

First, imagine how Tina Fey would have mercilessly parodied Palin, had she uttered such an incoherent non-sentence.

Second, contemplate the sort of idiot that believes that 'taking some of the profit motive out' will 'incentivize the private sector'.

As I understand the root problem, if we do nothing right now, soon Medicare and Medicaid will become a bigger and bigger percentage of the federal government budget. Eventually they will swallow the entire federal budget.

Under Obama's leadership, the Democrats are taking proactive steps to solve and avert this crisis.

Their plan is to make the federal budget so large that Medicare and Medicaid can't possibly swallow it.

"These impositions into people's lives via television are only going to grate on normal Americans, and drive down his political capital and popularity further."

I work with TV Guide, so they send me their daily press releases. Today's was:

Sixty-one percent of poll voters say they would rather watch their regular shows than Obama, who will appear in his fourth prime-time news conference Wednesday. Thirty-nine percent appreciated the president's efforts to keep Americans informed.

Last time I checked 61% was a helluva lot more than the 47% who voted against him last fall. He's even grating on the nerves of his own voters at this point.

Was the president correct in stating he has cut 2.2 Trillion Dollars over the next ten years out of the spending Trend line Bush was on?

Didnt hear it, but during the campaign, Obama made the same claims against McCain by attributing that McCain would keep 200,000 troops in the ME for 10 years spending at the rate (including all that reconstruction money) that we had in 2005-2007

"Was the president correct in stating he has cut 2.2 Trillion Dollars over the next ten years out of the spending Trend line Bush was on?"

Not even close. Obama gets that bogus number by projecting out Iraq war expenditures for the next 10 years as if we were going to keep spending that amount of money for the next decade.

There's no one, including Bush, who was ever expecting to spend that kind of money. Expenditures were always slated to drop as the pace of operations did and we reduced our presence in the country.

It's just more dishonest gimmicks from Obama, and his hack economic team.

[And as far as the "deficit" that he inherited: he voted for those budgets as a senator and supported the original TARP too, so he didn't "inherit" anything. He got exactly what he voted for, so even blaming Bush is a lie in and of itself.]

Kathleen...What you are reacting to is to a master practitioner of sexual-majick which is being used by Barak Obama to seduce his audience. The usual passionless demeanor of Barack Obama is a result of his having sublimated all his soul's sexual energy into a connecting with his target audience. You are one of the few who are immune to Barak's "gift". Someone alert Crack Emcee.

Seven, Thanks... I've seen that graphic many times and that's why I'm so confused as to not only how he could claim any deficit savings at all, let alone $2.2 trillion, but why no one has pointed out the lie in their analysis.

[And as far as the "deficit" that he inherited: he voted for those budgets as a senator and supported the original TARP too, so he didn't "inherit" anything. He got exactly what he voted for, so even blaming Bush is a lie in and of itself.]

and dont forget that the Democratic Congress didnt pass a budget till February. we were under a CR till then because the greedy mutts knew they would have a better majority and a willing President to pork up the 2009 budget if they waited for Obama.

"Thirty-nine percent of Americans. That seems a little high, but I'm sure the shine hasn't worn off for the many who want so badly to believe."

Somewhere around 25% of Americans define themselves as "liberals." They're never going to admit that they don't want to see Obama on TV. Add another 13% of the population which is African-American and has a 97% approval of Obama. Take out a few percent for overlap between those two groups and add back those few percent who are actually hard-core liberals but refuse to call themselves such.

You're at pretty close to 39% right there. It just shows how few people outside of his hardcore base are actually buying his BS any more...and how soft his current approval ratings are.

I had a friend who died of colon cancer, years ago. She was only 32. She had no health insurance, but Methodist Hospital in Memphis took care of her, knowing that they'd never get their money. They even resectioned her colon around the tumor to give her a little more time, this after they'd told her that her cancer could not be treated.

"1) Soundbite of the evening: Obama's comment that People are going to have to give up procedures that don't make them better." Then we are better off as we are now, because Obama would not have let the hospital prolong her life.

Laura(southernxyl) said... Wow, he's running up the basketball court with a full platter in his hand. Is our president talented, or what? How lucky we are that SP didn't win the presidency.

Had she won, by now she would have quit. Rationalizing that she would effectively be a lame duck.

======================Hayden - How exactly is the proposed health care bill going to help control the budget? I would think a little less "stimulus" and pork barrel spending would do a lot more for bringing the budget under control. And how does mandating coverages for everyone and eliminating most choice in policies help in the least in "your premiums and out-of-pocket costs will continue to skyrocket"?

1. You lower costs if you achieve what the Japanese and the better N European plans have accomplished. Good health care at 1/3rd the national per capita cost of the undesigned American model.

2. To the extent that investing a trillion now saves 6-8 trillion in costs later, it is a smart investment for the nation.

3. Mandating coverage and having a regular plan vs. a plan individuals and employers gamble will allow lower costs and the taxpayer picjk up the tab for shortfalls best ensures lower costs. It is also indicative of this national, "we're all in this together mentality" we demand. We can't achieve collective lower premiums for all if gamblers and employers choose less coverage - opt out and assume they have lots of money for other things and society will pick up the slack for unexpected major medical expenses.Similar to the complaining of Americans that don't have kids in school and don't want school taxes, or would "choose" to pay less taxes themselves for military defense on grounds they don't live anywhere near a likely target.

Sixty-one percent of poll voters say they would rather watch their regular shows than Obama, who will appear in his fourth prime-time news conference Wednesday. Thirty-nine percent appreciated the president's efforts to keep Americans informed. Last time I checked 61% was a helluva lot more than the 47% who voted against him last fall. He's even grating on the nerves of his own voters at this point.

61% (at least) of Americans at any time would rather watch their regular shows than the President. That's nothing new, and actually a sign of a healthy society that doesn't live and die for politics. Hell, I support Obama, and spent the evening having a pleasant dinner with my kid rather than watching him on TV. In other words - meaningless statistic.

"Then we are better off as we are now, because Obama would not have let the hospital prolong her life."

That's the tragic truth. I think we all have stories like yours of people who were the recipients of outstanding medical care performed by people who truly cared about their patients and knew they'd probably never get paid a dime for their efforts. A government bureaucrat never ever once had to look a patient in the eye and tell them that according to actuarial methodology and "best practices" their life isn't worth it. I don't know of a doctor worthy of the title who ever would.

It's precisely why Obama's statement that doctors were diagnosing and treating based on what best serves their bottom lines is so incredibly offensive. I wasn't sure I could dislike the man any more than I already did, but he managed to sink to a new low tonight.

If Palin were a Goddess she would be unknown to mankind. Fore as it is written that one from the North will arise, in fire and ice, and bring sobriety to those suffering in the anxiety of their time. They will feast on moose burgers and cleanse their pallets on Alaskan lemon sorbet. So shall it be, let it be done.

"C'mon 7, you're smarter than that. You must have heard of "contracts of adhesion.""

When my wife gave birth, we had to argue with a couple of different insurance companies (health and short-term disability) to get our expenses paid. But we ultimately prevailed and got paid.

Try arguing with a government bureaucrat who knows that he can't be fired and you can't sue no matter what he says or does. And good luck trying to go over his head to his supervisor who knows the same thing.

Pretending that there's no difference between the private sector and government is dishonest, and you know it.

1. You lower costs if you achieve what the Japanese and the better N European plans have accomplished. Good health care at 1/3rd the national per capita cost of the undesigned American model.

I'd have thought you of all people would have noticed, but our lifestyle and demographics are completely unlike those of Japan or Sweden. Therefore, importing those healthcare models into the US and expecting them to produce similar life expectancy results is unrealistic.

And can you name one US government program that is cost-efficient? Is there any reason to think this will be the first?

"A government bureaucrat never ever once had to look a patient in the eye and tell them that according to actuarial methodology and "best practices" their life isn't worth it. I don't know of a doctor worthy of the title who ever would."

That's because doctors value their lives.

Any doctor told me that, I'd grab him by the throat and ensure that fucker understood the real value of life.

Previous commenter asks: 'Ok, who in this world can map out the major specifics of the Obama plan?"

There is NO Obama plan! That way Obama can say anything in his press conference because his plan is fungible. Totally. One thing is constant: we must rush to pass whatever health care bill comes out of Congress. What is in the actual bill does not matter to Obama.

"Multiple studies have shown that people will tend to support government programs IF THEY BELIEVE that there is an elite faction of society that has things better than they do."

Very true. But it only works if people believe that the government program is going to get them the same thing those "others" have. Obama thinks that people actually believe that the government plan is going to be equal to what Congress receives. That's the fundamental disconnect between him and the public.

The public knows their plan isn't going to be anything like the gold-plated plan that Congress enjoys, and that's why the poll numbers keep going down every time he opens his trap.

apparently southernxyl believes Obama when he says his health plan will not run up the deficit. Because I don't see another reason why Obama would deny care to anyone.

No, ftl, I believe Obama when he said that people will have to give up procedures that don't make them better. The colon resectioning did nothing for my friend's cancer, ergo it didn't make her better. So he would have wanted her to give that up. But you get that, right?

As for the insurance company deciding what a person can have - no, they don't decide that. They can't. They decide what they will or won't pay for, period. You can make your own arrangements if they won't pay - people do it all the time. I have, myself.

"Multiple studies have shown that people will tend to support government programs IF THEY BELIEVE that there is an elite faction of society that has things better than they do."

I think Ben Franklin said as much, as well. Something to the effect of (not a direct quote), "the more people see themselves as the losers of society, the more they desire a King because a King can level the playing field by taxing the winners down to the loser's level -- and the King will tax those winners all the more the louder they shout in protest so as to pay off his constituents to stay in power."

Most dishonest Presidential news conference I ever saw, including all the way back to Nixon. I have a quarter century of experience managing health care for employees and myself. I've used mine like a dog uses his tongue - for everything and all the time.

Laura sxl: "...People are going to have to give up procedures that don't make them better."

Then we are better off as we are now, because Obama would not have let the hospital prolong her life.

I've had the same thought. Why would even those of are uninsured want sub-par care compared to what we can have now?

FLS wrote: apparently southernxyl believes Obama when he says his health plan will not run up the deficit. Because I don't see another reason why Obama would deny care to anyone.

So do you believe him or not fls?

And he not only says it will not run up the deficit (if it weren't BO, I'd ask what he was smoking) he also clearly, repeatedly, states that we can't get some treatments which are now available and offered to people.

The latter appears to be in the plan, especially looking at coontries with nationalized health services. The former is impossible.

apparently southernxyl believes Obama when he says his health plan will not run up the deficit. Because I don't see another reason why Obama would deny care to anyone.

Not quite sure of which side of the debate you are on here, but...

Let's work backwards a bit. The reason that your unnamed bureaucrat would deny coverage is that he has a budget that has been busted. He himself may not have one personally, but the system as a whole does.

The problem is that the more you disconnect paying for a good or service from receiving it, the more disconnect there is between the supply and demand curves. If a good is free, demand approaches infinity (not really, but that is because there are non-economic costs too). But when price drops below cost, then supply also drops. So, you have a lot of demand and almost no supply. As most here recognize, this is Econ 101.

We see this already to some extent with Medicare, Medicaid, etc. Demand is substantially higher than supply because those receiving them don't pay nearly full boat for them. The safety valve right now is that there are a lot of us paying ever more of our paychecks for Medicare, and there is massive cross-subsidization going by everyone else. But this is coming to an end, as the disconnect is getting to the point that doctors are now refusing new Medicare patients (including, apparently Sonia Sotomayor's brother).

The problem with any public option is similar to that faced with Medicare, etc. You have high demand, and ultimately low supply, caused by the participants not paying for their health care. So, the money has to come from somewhere to cover the costs, and that means budget deficits. The only way to limit that in the long run (esp. as cross-subsidization by everyone else is becoming increasingly hard) is through rationing, which includes telling people that they won't get treatment that they think or actually do need.

But it is likely to work both ways, with the deficit being run up AND rationing, just because of the magnitude of the problem. And the more people participating in the public option, the worse this is going to get.

A private company is at the public's mercy. If they screw people over, their reputation is ruined, and they're out of business. Not so with the government. They can plan and socially engineer however they'd like, and they're beholden to no one.

Sure, you can threaten to vote an elected representative out, but you have to vote based on a whole host of issues, healthcare being only one. Thus, the system would be FAR less responsive.

Ask people who've had to use their insurance how it's gone for them. My father is making HUGE use of his private health insurance right now as he goes for cancer treatments at MD Anderson. No one has tried to screw him over.

I wonder if the government would authorize his going from Tulsa to Houston for state of the art treatment, or if that would fall under the "you have to give up things that [we the bureaucrats think] won't make you healthier" rubric.

I love how he admitted he "doesn't know the facts", but the Cambridge "police acted stupidly".

Jerk.

From the accounts I read today, the police were satisfied after seeing his ID and when leaving were verbally berated for racisim, etc, etc., leading to the arrest which was not about him breaking in but how he behaved AFTER THE INCIDENT WAS RESOLVED.

Whoever runs against Obama, all they have to do to win is promise not to be on TV every week.I felt the same way about Clinton by this time in 93. But the stakes were so much lower in his daily train wrecks. Their frequency helped him in the long run because of scandal-fatigue.

A private company is at the public's mercy. If they screw people over, their reputation is ruined, and they're out of business. Not so with the government. They can plan and socially engineer however they'd like, and they're beholden to no one.

The first part of that paragraph is terribly naive. Private insurance companies screw people over all the time, and can and do go on with their business. As far as government goes, there are no shortage of pressure groups and government watchdogs around to make government (somewhat) responsive. I'm not going to sit here and say that government is always the best solution (because it isn't) or always responsive (because it isn't), but the idea that big insurance companies aren't big bureaucracies that are largely insulated from having to deal with individual complainants is just absurd. And most people see that - hence the support for some kind of health care reform (you won't find many Republicans against some sort of reform, at least rhetorically), though the specifics, as always, are where the controversy is. Either way, it's pick your bureaucracy, and any claims to the contrary should be dismissed.

"C'mon 7, you're smarter than that. You must have heard of "contracts of adhesion.""

Let me add to my last point there, that insurance companies can put anything they want in a policy. And they can maybe even get you to initial every paragraph, maybe even line, showing that you have supposedly read and understood them.

But when something goes wrong, and you have a sympathetic plaintiff, who could have been helped, or maybe even cured, if the insurance company had just acted in good faith in making coverage decisions, then the adhesion provisions are likely not going to be worth the paper they were printed upon in protecting the insurer.

The legal justification for ignoring adhesion contracts is public policy. Many courts, and many more juries, just do not like insurance companies screwing their policyholders through reliance upon fine print that the policy holders likely did not understand.

In the end, it typically turns into a battle of the experts, with the insurance company trying to show that their denial was reasonable, and the plaintiff's experts trying to prove the opposite. But the downside is far worse for the insurance company in many of these cases because of pain, suffering, and punitive damages.

"If there's a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that's going to make you well?"

Hm. Because the blue pill works for 65% of people with condition X, and you're in the other 35%? Because the blue pill has side effects that you can't tolerate, and the red pill doesn't? Because you're taking another drug that interacts with the blue pill but not the red pill?

Is his thinking really this rudimentary and simplistic? Or does he think he is talking to a stupid audience?

Since the left loves the tear jerker story let me tell you about my father.

He was in an HMO as his supplement to Medicare. This was back in the 90s. He had worn out his hip socket. Not hard to understand as he was in his early 80s. (He worked for himself into his 70s.) It was painful.

The verdict was "Take Motrin." (Obama's "Take a pain pill!")

He did not accept that. This is a man who had driven across the country every year for 30 years. He switched to another provider, saw an orthopedist (which the HMO would not have him evaluated by), had a hip replacement, and lived another 9 years. He died of a heart attack in California after flying west with my mother to spend Thanksgiving with my sister.

So. My father should have eaten Motrin until he died (perhaps of a gastric bleed from the Motrin) because he was too old.

The first part of that paragraph is terribly naive. Private insurance companies screw people over all the time, and can and do go on with their business. As far as government goes, there are no shortage of pressure groups and government watchdogs around to make government (somewhat) responsive.

I am still waiting to see the government be responsive to much of anything, except the possibility of making those that deal with it and run it rich.

Let's talk reality checks here. Yes, there are a lot of pressure groups, and the all pretty much cancel each other out. That is one reason that governments are so inefficient.

The only downside to the government screwing someone is if the politicians running it don't get reelected. But most often, that is not a real issue. There are so many other issues involved, that screwing someone here or there just doesn't affect reelections. Besides, the politicians can always blame it on the (unfireable) government bureaucrats.

Obama's slam on doctors doing procedures which cost more money so they can pad their pockets makes my blood boil.

Is he really that naive? Does he believe that thimerosal causes autism too? Or that we have discovered the cure to [insert favorite awful disease] and that the FDA and the doctors are in collusion covering it up so they can make more money?

He's playing the class warfare crap again. Alinsky from Day One.

My daughter is an ED doc, and she has more than one time in the last couple years mentioned that it is the self pay (read: uninsured) people who are diligent about making sure they pay.

I agree with Freeman, who says: "Ask people who've had to use their insurance how it's gone for them. My father is making HUGE use of his private health insurance right now as he goes for cancer treatments at MD Anderson. No one has tried to screw him over."

That's been my experience too, through my mother's aging and death after multiple health problems, my wife's death of cancer and my own treatment for leukemia. Never once has a private insurer tried to deny a coverage for a needed procedure or medication. Never once have I had any sense that the doctors or the hospitals are recommending procedures to increase their incomes. Sometimes the bookkeeping was a nightmare, but the companies always tried to set it right and many individuals at the companies took time to solve complicated issues.

Now, have the doctors gotten paid fairly? They certainly did until I went on Medicare about a year ago. Now some of their payments are so low I can not understand why they would continue to treat me. But of course they do.

This is a real issue. If all you need is Motrin, then you are (still) in pretty good shape. SO would be needing heavy narcotics, if she had not gotten some back surgeries, where the insurance company did push for pain meds as an alternative. But because it was private insurance, they eventually backed down and paid for the back surgeries.

The problem is that heavy duty narcotics over a period of time significantly reduce one's life span. Of course, that may be considered a feature, and not a bug, by some.

And this is really what Obama is pushing here - heavy dosages of pain meds throughout the rest of people's significantly shortened lives. Do you really want to spend the rest of your life like that, if the alternative is an operation that costs more up front? Seeing what surgery can do in such a case, I know my answer.

The idea that there's ever real pressure on details of government is absurd. Say a watchdog group says they're doing something wrong. So what? Unless it's far and away the most egregious thing the government is currently doing (a terribly high bar) nothing will happen.

You hear a company's coverage sucks, you drop it and switch providers. You hear the government's coverage sucks, you write to your elected officials, you apply "pressure," and then it's time to vote. But government is huge. It runs a lot more than healthcare.

So, do you vote your rep out because he didn't act on the healthcare thing? You agree with him on other issues. That guy running against him is wrong about trade and foreign relations and taxation. Hmmmm.

Individuals who work for big bureaucracies of any type don't have incentives to please anyone, other than the fact that they might get in trouble with their bosses if complaints rack up. That latter point is not a trivial one in the real world of government and business, and the world of complaints, either individually or through pressure groups or the media, does count for something. Squeaky wheels, and all.

What is naive is the libertarian (and I'm not sure that's the right word, most thoughtful libertarians have a skepticism towards big business as well as big government, because they can see that the two often work together and are largely indistinguishable from one another) idea that the private sector will always be more responsive than the public one. That might be true in a totalitarian state, but not true in a society like ours. And quite frankly, if you think that Obama is creating a totalitarian state (and I'm not aiming this at you Freeman, unless you believe this), then you are a nutter and an idiot. Sorry, I'm not going to mince words on that point, and there are more than a few commenters who seem to think (or at least like to play that for rhetorical grins) that is around the corner.

You hear a company's coverage sucks, you drop it and switch providers.

1. They all suck.2. Only one out of nine insured obtains insurance directly from the insurer. The rest get it through their employer. I suppose one could pick his employer based on their health insurer (if you want to get a reputation as a kook). Or perhaps you could try to rise high enough in the organization to have some say in the choice of insurer.

"People: please construct a plausible scenario in which government bureaucrats are incentivized to deny care."

I have two words for you: "best practices." "Best practices" is another word for actuarial analysis of treatment rather than examining the human cost.

It's not just plausible: Obama himself said that's the way he was planning on doing business. Even in his own infomercial, he admitted that some treatments just wouldn't be available under his plan if they could get away with just giving the patient a pill instead.

You hear a company's coverage sucks, you drop it and switch providers.

1. They all suck.

fls, if you had a molecule of credibility left, you just shredded it.

People have posted on here and talked about the stuff their insurance companies paid for. They were the ones affected and they said that they were satisfied. You contradict them to assert that their insurance companies all suck. Do you even see how stupid that is?

"The idea that there's ever real pressure on details of government is absurd."

I don't think this comment stands the test of history.

The Bureau of Alcohol, Tobacco and Firearms was definitely pressured into changing its tactics after getting most of its people killed in the raid on the Branch Davidians.

The government certainly did not employ the same procedures against the El Dorado "polygamist" compound.

What the government figured out after Waco was that, if you decide to take the military in and burn Americans do death, then maybe we'll just bomb your federal buildings and you're probably unprepared for that.

So that government changed its tactics to merely lying on search warrants.

Which, in the grand scheme of things, is probably a better result than burning babies to death.

You are incorrect. Most people don't have frequent bank-breaking illnesses. I pay TONS of money into my insurance provider, but I'm rarely ever sick, so I take little out. Most customers are like me. Thus it works without the screwing.

People: please construct a plausible scenario in which government bureaucrats are incentivized to deny care.

Government programs run on rules."I need to red pill.""I'm sorry, but according to federal healthcare guidelines section 8, sub-section 48, item 983, provision for the red pill is not allowed. The blue pill, however, is available."

Now why is the red pill not provided for by the govt? Could be any number of reasons: (1) Government moves slowly. There must be a committee about the pill and a hearing and a series of approvals, blah blah blah red tape. (2) The lobbyist for the company that makes the blue pill pays for fancier dinners. (3) Some disgusting little social engineer somewhere wrote it that way because he, like Obama, doesn't believe that extending the lives of old or sick people is important.

Hell, Obama has flat out told you already that they'll be rationing care. Even if you fail to understand why, please note that the guy trying to sell you on the scheme has already admitted it.

"I suppose one could pick his employer based on their health insurer (if you want to get a reputation as a kook). "

I have worked for more than one corporation, including in human resources, where complaints from employees brought about changes in the company's health insurance provider. Companies that have a reputation for providing crappy benefits don't retain the best employees and the vast majority of them know that. It's not in their self-interest to do so.

People: please construct a plausible scenario in which government bureaucrats are incentivized to deny care. They cannot simultaneously be indifferent time servers and actively evil.

Their agency, etc. has a certain amount of income (let us assume Medicare right now, with our Medicare payroll taxes being the primary component of that income). They face increasing costs, worsening demographics, etc. What does the agency do?

Among the solutions that they have implemented is cutting back on the procedures that they will authorize.

You ask whether government bureaucrats can be both indifferent time servers and actively evil. Probably not. I have met few actively evil government workers. Indifferent time servers? Plenty.

But you have posited a false dichotomy. More likely is the situation where the mindless time server is incentivized to deny coverage. At the higher levels, it may be through bonuses (and, yes, government employees get them at the higher levels). At the lower levels, at the level of the people actually making the decisions, the incentive is to look good for their next review, so they can get their next step or grade. And if the criteria set (by the people high enough up to get bonuses) call for staying within a certain budget, then that is what they are going to do, many regardless of the pain and suffering it may case.

Also keep in mind that if they might have moral qualms about this, there is so much fraud and waste in programs like Medicare, that many of the bureaucrats working in such systems become quite cynical about many of the public/ patients they have to deal with.

I remember when liberals use to argue with death penalty advocates. The advocates would claim that the appeals process prolonged the inevitable and caused to society to incur unnecessary costs. Liberals would claim the sanctity of life, the consequence of being wrong, and the threat of government abuse.

Now, we have a Democratic President and Congressional leaders stating we should tell a person diagnosed with cancer that they should acknowledge the inevitable and just die with dignity, because it is for the economy.

If I had complained at my old work place about the insurance, they would have looked into it, and if the insurance really was bad, they would have switched carriers. As has already been noted, companies want to keep their good employees. They do it by being responsive.

Bureaucrats have a single, overriding incentive: carry out the law as they are instructed.

Actually, I would suggest for many of them, that isn't their overriding incentive. Rather, it is to retire with the maximum amount of benefits. This likely means moving up as far as they can in the hierarchy, both in grades and steps. And for many, doing so with the minimum amount of work and brain damage.

Yes, there are idealistic government workers. But it seems like so many of them burn out one way or another. They either bail (like I did fairly early) before then, or they take on-the-job retirement.

"If I had complained at my old work place about the insurance, they would have looked into it, and if the insurance really was bad, they would have switched carriers."

Exactly. Even if the corporate suite shows little interest in the welfare of their employees (an increasingly rare phenomenon), no HR department wants to spend their days fielding complaint after complaint about the crappy insurance carrier they're using.

Having worked in one, I can tell you that the first priority of the HR department then becomes convincing the powers-that-be that "something needs to be done" about that carrier ASAP. No CEO ever succeeded by pissing off his HR people, and even the halfway decent ones know that.

Oh, and then there is Obama quipping that a patient just needs to use pain killers. Only problem is that the DEA and the FDA have been on the warpath against narcotics for decades. Doctors are monitored for prescriptions of narcotics and threatened if they prescribe too much. This has been a real problem for doctors who specialize in pain management.

Then there is the recent near miss when nanny statists tried to get acetaminophen pulled from products and even added to a controlled substance list.

A qualified health benefits plan may not impose any pre-existing condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act) or otherwise impose any limit or condition on the coverage under the plan with respect to an individual or dependent based on any health status-related factors (as defined in section 2791(d)(9) of the Public Health Service Act) in relation to the individual or dependent.

Sweet. So we can all buy super cheap plans with few benefits and then get fully featured plans when we're actually sick. That won't completely destroy insurance in the private sector...

And what is all the "no cost-sharing" stuff? Does that mean no co-pays? No 80-20 splits? If so, I guess we can all go to the doctor all the time absolutely free. "Sure, doc, I'd like every eligible service you've got. Not like I'm paying for it."

How do for-profit insurers return money to their shareholders then? Surely they're at a competitive disadvantage compared to non-profits.

I learned years ago that private health insurance is inefficient, and makes profits by denying care. A friend's mother worked for a family practitioner. She was one of two women who worked full time filling out insurance forms and following up with insurers until they got paid.

Another friend's girlfriend, an RN, made her living by denying treatment plans for a big insurer.

Plus - your civil service will inherently grow corrupt, and your betters (your elected representatives) won't be any better. Heck, we can't get rid of Rangel or that guy in Louisiana who stuffed cash in his freezer. You think the suffering of your child from cancer or the death of your wife from a broken hip is going to move a bureaucrat?

You live in a dream world.

I have had to deal with the federal government bureaucracy once, for a period of three years. In that three years, we as a family went through personal hell as we tried to navigate and negotiate the various agencies involved, and at no time did these agencies express any interest in actually helping us or leaving us alone. In the end, the bureaucracies totally won; we got nothing.

So I have some personal experience with the "caring" bureaucracy. As 7M said, they're interested in following their policy, not in solving problems. People impacted by their decisions are simply inconveniences.

"Let's just lay everything on the table," Grassley said. "A Democrat congressman last week told me after a conversation with the president that the president had trouble in the House of Representatives, and it wasn't going to pass if there weren't some changes made ... and the president says, 'You're going to destroy my presidency.' "

That's the first line of their story. When that's the best thing that a mouthpiece like TPM can say about your primetime press conference, you know you stepped in it big time.

Leaving aside that he actually did make quite a big of health care news, TPM couldn't find a single thing to point to in order to say that he achieved his goal of moving the ball further down the field.

It's hardly a surprise that they failed to note any of the things we're discussing here: slamming doctors, removing profit motives, or even the lies he told that even the AP has already fact checked.

FLS, you're going wrong when you lump all private insurance together. The whole point of leaving it in the private sector is that you can choose between carriers. There is a market. One company might blow, but another doesn't.

The government, however, is the government. It's them or... well, I suppose you could renounce your citizenship and move elsewhere but that seems like a drastic requirement for selecting a different insurance provider.

In fact, it's largely government's fault that insurance companies aren't more responsive. Most of us have to pay for coverage we don't even want because government dictates that certain things must be covered and plans cannot be offered without meeting certain criteria.

If we had an open market with less government interference, things would be much better.

I've had various insurance plans over the decades. During that time, I've had two broken legs, multiple ER visits, my first child was born prematurely, my second was born C-Section. My wife had kidney stones twice. I had a gall bladder removed and a vasectomy. My kids and I have received stitches. My daughter had an ER visit and a bady.

I have never had a claim rejected. I did have to fight with UNC over claims, but they were ultimately paid (in part thanks to a visit to a great CEO who acted and lit the fire under HR. UNC was dropped for fantastic insurance the next year.)

"Sweet. So we can all buy super cheap plans with few benefits and then get fully featured plans when we're actually sick. That won't completely destroy insurance in the private sector..."

That's exactly what's happening in Massachussetts with their universal health care. It's also led to a mass exodus of doctors from the state.

But hey, don't let your lying eyes deceive you. FLS says that universal health care is better, so the fact that it almost destroyed Tennessee's state budget and has had to be rolled back repeatedly and it has absolutely trashed the health care system in Massachussetts shouldn't deceive you at all.

FLS will personally guarantee that everything will be fine if you just lie back and swallow the blue pill like Obama told you to...

Oh, and I would point out that the government already kills people everyday by denying care.

Treatments cannot be made widely available until they are FDA approved. Meanwhile, people die. Even people who are terminally ill cannot try whatever treatment they'd like. You'd think that if you were already sure to die, you should be able to try absolutely anything you wanted. But no. You can try to get into a clinical trial of the treatment you want, but if you don't fit the precise criteria for that particular trial, you can forget it.

Not only that, but the President tried to claim that "separate and apart from this incident is that there’s a long history in this country of African-American and Latinos being stopped by law enforcement disproportionately."

The facts just don't support such a racist notion. Blacks and Hispanics are disproportionally underrepresented when it comes to law enforcement - according to the New York Times.

Have a look at this Times graphic, which details murder in New York City for the past six years.

Blacks and Hispanics committed an astounding 90 percent of all murders in this time period in New York City.

When Blacks and Hispanics are murdering 90% of the total people murdered America's largest city, then there is an endemic problem within the black and Hispanic communities that has nothing to do with Louis Gates crying wolf when police are called by his neighbors upon seeing a black man breaking into his house.

When Blacks and Hispanics are killing 90% of the people murdered in New York, there's a real problem there that Obama doesn't seem capable of seeing or dealing with.

"If universal care is so great, ,let one state -- one municipality, one hamlet -- pull it off for five years before we try to do it with the largest capitalist economy in the world."

The state of Massachussetts has tried it. A whopping 26% of the population is pleased with their healthcare.

The state of Tennessee tried it, and after everyone started dropping off private insurance and enrolling in the government plan it pretty much bankrupted the state. They're now engaged in lawsuit after lawsuit trying to reduce their eligibility requirements in order to force people off the rolls.

We have seen how it works in this country, and it is an abysmal failure.